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ForumsPsychological & BehavioralThe psychological adjustment to rapid weight loss — need advice

The psychological adjustment to rapid weight loss — need advice

denise_HTX Tue, Jun 24, 2025 at 2:06 AM 40 replies 1,403 viewsPage 1 of 8
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denise_HTX
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Jan 2025
Houston, TX
Jun 24, 2025 at 3:31 AM#1

I have spent 25 years of my life being told, in various polite and not-so-polite ways, to "just eat less and move more." By doctors, family, strangers on the internet, well-meaning friends, and the voice in my own head.

And I tried. God, I TRIED.

  • Weight Watchers (three times)
  • Keto (twice)
  • Whole30
  • Calorie counting (years of it)
  • Intermittent fasting
  • A personal trainer I couldn't afford
  • A nutritionist who put me on 1200 calories and wondered why I was "non-compliant"

Each time: initial success, eventual failure, deeper shame. Repeat. For DECADES.

I started semaglutide 6 months ago. I've lost 55 lbs. And the weight loss isn't even the point of this post. The point is: I finally understand that I was never the problem.

My brain chemistry was the problem. My hunger hormones were the problem. The absolute AUDACITY of telling someone with dysregulated appetite signaling to "just eat less" is like telling someone with clinical depression to "just cheer up."

I am furious. And I am free. And I needed to say this somewhere.

28 22sarah.morrison, NeuroNate, JessicaH_TX and 25 others
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PedsEndoPhilly
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1,890
Jun 2024
Philadelphia, PA
Jun 24, 2025 at 3:48 AM#2

Every word of this. EVERY. WORD.

The 1200 calorie nutritionist. I had one of those too. She weighed me weekly and when I inevitably gained after the initial loss, she'd look at me with this gentle disappointment and say "were you really tracking everything?" As if I was lying. As if I was sneaking food and hiding it from her like a criminal.

I WAS tracking everything. I was starving. My body was fighting me with every hormonal weapon it had. And she made me feel like a liar and a failure.

I'm on month 7 of tirzepatide now and for the first time in my life, a moderate caloric deficit feels EASY. Not because I finally found willpower. Because my body is finally cooperating. The medication fixed the BIOLOGICAL problem that willpower could never touch.

We weren't weak. We were sick. And nobody told us.

12 12wendy_avl, jason_paloalto, Dr.LeslieOBGYN and 9 others
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jason_paloalto
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Nov 2024
Palo Alto, CA
Jun 24, 2025 at 4:05 AM#3

Research scientist here. I want to back up what you're feeling with some data, because the science is unequivocal on this.

Obesity is a neuroendocrine disease, not a character flaw. Here's what the research shows:

  • After weight loss through caloric restriction, the body mounts a coordinated hormonal counterattack: ghrelin (hunger hormone) increases, leptin (satiety hormone) decreases, metabolic rate drops, and the reward value of food increases. This persists for years after the weight is lost.1
  • Long-term studies show that 95% of people who lose significant weight through diet alone regain it within 5 years.2 This is not a failure of willpower — it's biology defending a set point.
  • The "just eat less" approach fails because it treats the symptom (excess intake) without addressing the cause (dysregulated appetite signaling).
  • GLP-1 RAs work because they address the biological root: they mimic a hormone that your body isn't producing sufficiently, restoring the appetite regulation that was broken.3

Telling someone with obesity to "just eat less" is, from a scientific standpoint, as reductive as telling someone with Type 1 diabetes to "just make more insulin." The mechanism is broken. The medication fixes the mechanism.


1 Sumithran et al., "Long-Term Persistence of Hormonal Adaptations to Weight Loss," NEJM, 2011.
2 Fildes et al., "Probability of an Obese Person Attaining Normal Body Weight," American Journal of Public Health, 2015.
3 Wilding et al., "Once-Weekly Semaglutide in Adults with Overweight or Obesity," NEJM, 2021.

38 0mona_PHX, andrew_nyc, Dr.EndoEP and 35 others
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RetaRick_CA
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Jan 2024
California
Jun 24, 2025 at 4:22 AM#4

I'm going to say the thing nobody wants to say:

A lot of thin people's entire sense of moral superiority is built on the idea that weight is a choice. That THEY are disciplined and WE are lazy. That their thinness is an accomplishment and our fatness is a moral failing.

GLP-1 medications are threatening to that worldview because they prove that weight is largely biological. And some thin people are BIG MAD about it. "That's cheating." "You're taking the easy way out." "What happened to personal responsibility?"

What happened is science happened. And it turns out your "discipline" was just your neurochemistry working correctly the whole time. Congratulations on your functional GLP-1 receptors. You didn't earn them.

Sorry. I'm bitter today. But I'm also right.

5 3nick_newbie, DadBodDave, AmyNC_wife and 2 others
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NeuroNate
Senior Member
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Dec 2023
Chicago, IL
Jun 24, 2025 at 4:39 AM#5

I hear the anger and I think it's valid. But I also want to offer a slightly gentler framing, not for the sake of thin people, but for our own peace.

Most people who say "just eat less" aren't being malicious. They're operating from a model of reality where weight = calories in minus calories out, full stop. They don't know about hormonal adaptation, set point theory, or neurochemical reward dysfunction because nobody taught them. We didn't know either, until we lived it.

That doesn't make it okay. It makes it ignorant. And ignorance can be corrected with education, which is exactly what threads like this one do.

Save your fury for the systems — the medical establishment that undertrained doctors in obesity medicine, the diet industry that profited from our repeated failures, the insurance companies that still won't cover these medications for millions who need them.

The individual people? Most of them just didn't know. And now they can.

5 17Dr.NephBHM_UK, kim_atl_prep, sarah_TO and 2 others
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